A Proposal to Prevent the "Mephisto Sign" Side Effect of Botulinum Toxin Type A Injection in Chronic Migraine.
10.3349/ymj.2013.54.6.1542
- Author:
Eunae S CHO
1
;
Jae Young HWANG
;
Seong Taek KIM
Author Information
1. Department of Orofacial Pain and Oral Medicine, College of Dentistry, Yonsei University, Seoul, Korea. k8756050@hotmail.com
- Publication Type:Case Reports
- Keywords:
Migraine disorders;
botulinum toxin type A;
eyebrows
- MeSH:
Adult;
Botulinum Toxins, Type A/administration & dosage/*adverse effects;
Female;
Humans;
Injections;
Migraine Disorders/*drug therapy
- From:Yonsei Medical Journal
2013;54(6):1542-1544
- CountryRepublic of Korea
- Language:English
-
Abstract:
Botulinum toxin type A (BoNT-A) has been reported as an effective treatment for chronic migraine. When BoNT-A is injected on the frontalis muscle for chronic migraine, an unexpected clinical side effect called the "Mephisto sign" may occur. The aim of this article is to propose a method to eliminate or prevent the Mephisto sign side effect. A 25-year-old female patient visited the hospital and was diagnosed with chronic migraine. A total of 155 U of BoNT-A was injected into 31 sites. 2-weeks later, and the patient developed the Mephisto sign. An additional 2-U dose was administered bilaterally to the lateral-most point of the frontalis muscles, and the eyebrow morphology returned to normal within 2-3 weeks. We propose that the development of the Mephisto sign may be prevented with an additional BoNT-A injection of 2-4 U bilaterally to the lateral most point of the frontalis muscles during the primary injection process.
